This resubmitted competitive continuation seeks to extend a highly successful longitudinal, diagnostic study of 345 tribally enrolled Ojibwe children (aged 10-12 years at wave 1) and 465 of their caretakers through adolescence and the high school years. The continuation would support four additional waves of data from ages 14 16 years through ages 17 19 years. This study and its companion study of 401 Ojibwe children and 511 of their caretakers (launched one year earlier) make up the only contemporary longitudinal diagnostic study of American Indian children at these ages.The overall goal of this continuation is to investigate the effects of early onset emotional/behavioral problems and mental disorders reported in the first four waves on adjustment, mental disorder, and mental health services utilization patterns during the critical high school years. The study will use prospective data to 1) investigate culturally specific protective factors that exist within the Ojibwe culture that may prevent, delay, or reduce the consequences of early onset emotional and behavioral problems and mental disorders;and 2) investigate risk factors that are associated with indiviudal characteristics and the historical and social contexts of Ojibwe children during their high school years. Our baseline data indicate the prevalence rate for a single mental disorder increased from 26.2 percent to 44.8 percent between the ages of 10-12 years and 13-15 years and that the prevalence of two or more mental disorders [more than doubled from 10.4 percent to 26.6 percent] (combined DISC 4.0 child and female caretaker reports). The historical and social contexts of reservations/reserve present a unique developmental context for American Indian and Canadian First Nations adolescents. This prospective study is ideally situated to investigate important cultural variation in developmental pathways: 1) it incorporates culturally adapted key constructs of risk and protective factors;2) it provides innovative new culturally specific measures of risk and protective factors that were created at the study's onset;and 3) it will provide information regarding the influence of early onset of emotional/behavioral problems and mental disorders on critical transitions and adjustment as the adolescents move through their high school years. The investigators are working closely with the tribal governments to translate these findings into empirically-based preventions aimed at reducing early onset emotional, behavioral and substance abuse problems among Ojibwe children. PUBLIC HEALTH RELEVANCE: This is the only current longitudinal diagnostic study of Indigenous adolescents beginning at ages 10-12 years and continuing through the high school years. The study has already documented a mental health/substance use crisis on the reservations and reserves with approximately one-fourth of the youth meeting lifetime criteria for conduct disorder or a substance abuse disorder at ages 13 15 years. The prevalence of lifetime single mental disorders is 44.8 percent, a rate comparable to that of adults in the National Comorbidity Study Replication. These results will guide prevention research in terms of optimal ages for interventions, gender specific risk and protective factors, and culturally specific risk and protective factors.